By Kate Kelland

LONDON, March 7 (Reuters) – Pfizer’s dementia drug Aricept, already commonly used to treat mild to moderate Alzheimer’s disease, can also help patients with severe disease and should be used more widely and for longer, according to research published on Wednesday.

British scientists who studied the possible longer-term benefits of giving Aricept suggested that extending treatment could help twice as many Alzheimer’s sufferers worldwide.

The study also looked at another commonly used dementia drug called memantine, which is sold in the United States under the brand Namenda by Forest Laboratories and Germany’s Merz, and in Britain under the brand Ebixa by Danish group Lundbeck .

It found that keeping patients with moderate to severe Alzheimer’s on Aricept, or donepezil as it is known generically, or starting them on memantine treatment, meant they had significantly better cognitive and function abilities than patients taking a placebo or dummy pill.

An estimated 18 million people worldwide suffer from Alzheimer’s disease, which is the most common form of dementia. It is fatal brain disease that affects memory, thinking, behaviour and the ability to handle daily activities and is placing an increasingly heavy burden on societies and economies across the world.

According to the World Health Organisation, some 35 million people worldwide have dementia, and Alzheimer’s Disease International predicts that as populations age, dementia cases will almost double every 20 years to around 66 million in 2030 and 115 million in 2050.

The study, published in the New England Journal of Medicine, involved 295 Alzheimer’s patients in Britain who were assigned to one of four separate groups – one continuing to take donepezil, one stopping donepezil and getting a placebo, one stopping donepezil and starting memantine, and a fourth taking both drugs together.

Robert Howard, a professor at King’s College London who led the trial, said it was the first to show the value of continued drug treatment for patients with moderate to severe Alzheimer’s.

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Public release date: 7-Mar-2012 [ | E-mail | Share ]

Contact: Katherine Barnes katherine.barnes@kcl.ac.uk 44-207-848-3076 King’s College London

The dementia drug donepezil (Aricept), already widely used to treat mild to moderate Alzheimer’s disease, can also help in moderate to severe patients, according to a report funded by the UK Medical Research Council (MRC) and the Alzheimer’s Society. The study suggests that extending treatment to this group could help treat twice as many sufferers worldwide. Encouragingly, the drug has greater positive benefits for patients more severely affected than for those in the earlier stages of dementia.

It is estimated that 18 million people worldwide suffer from Alzheimer’s disease, which is the most common cause of dementia. According to the World Health Organization, of the 35 million people currently living with dementia globally, 58% live in low- and middle-income countries and by 2050 this figure is projected to reach 71% of the total.

The multi-centre UK study, led by Professor Robert Howard at King’s College London, is the first trial to demonstrate the value of continued drug intervention for those patients with moderate to severe Alzheimer’s disease who have deteriorated beyond the point where donepezil is currently recommended.

The study, to be published in the New England Journal of Medicine, looked at two drugs: donepezil and memantine. Donepezil is the most commonly prescribed of the dementia drugs and is recommended for patients at the earliest stages of Alzheimer’s disease. Doctors are currently advised to stop prescribing donepezil when the disease progresses to become moderate to severe and until now there has been no clear evidence that continuing treatment is of benefit to patients.

Over the course of the trial, patients who continued to take donepezil showed considerably less decline in cognition memory, orientation, language function and function (retained ability to carry out simple daily tasks and self-care) than those taking a placebo drug. The benefits seen with continued treatment were clinically important and were greater than those previously seen in patients with less severe Alzheimer’s disease. Whilst the effect was slightly smaller, starting memantine treatment also resulted in significantly better cognitive and functional abilities compared with those taking a placebo.

Professor Robert Howard, lead author from the Institute of Psychiatry at King’s says: “As patients progress to more severe forms of Alzheimer’s disease, clinicians are faced with a difficult decision as to whether to continue or not with dementia drugs and, until now, there has been little evidence to guide that decision. For the first time, we have robust and compelling evidence that treatment with these drugs can continue to help patients at the later, more severe stages of the disease. We observed that patients who continued taking donepezil were better able to remember, understand, communicate and perform daily tasks for at least a year longer than those who stopped taking the drugs. These improvements were noticeable to patients, their caregivers and doctors. Both donepezil and memantine will soon be off patent and available in very cheap generic preparations. These findings will greatly increase the numbers of patients in the developed and developing world that we are able to treat.”

Professor Nick Fox, MRC Senior Clinical Fellow at the Institute of Neurology, University College London, says: “The number of people with Alzheimer’s disease and other forms of dementia is reaching critical levels. It has never been more important to invest in research which will enable doctors to make informed decisions based on the best evidence possible when deciding what treatments to give patients. The MRC has an ongoing commitment to the development of effective, safe treatments that will improve the quality of life for people with Alzheimer’s disease and their care givers.”

Professor Clive Ballard, Director of Research at Alzheimer’s Society, says: “Thanks to the Alzheimer’s drug donepezil, tens of thousands of people in the early to moderate stages of the condition are able to recognise their family for longer, play with their grandchildren and make vital plans for the future. This major new trial now shows that there could also be significant benefits on continuing the treatment into the later stages too. There are 750,000 people with dementia in the UK yet currently prescription levels of Alzheimer’s drugs are still low. If this is to change we have to improve the shocking diagnosis rates and ensure everyone is given the opportunity to try treatments.”

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The bill for taking care of people with Alzheimer’s and other dementias will reach $200 billion this year in the United States, including $140 billion paid by Medicare and Medicaid, the Alzheimers Association said on Thursday.

The group estimated that 800,000 Americans have Alzheimer’s and live alone, and as many as half dont have any set person to help care for them.

“Alzheimer’s is already a crisis and it’s growing worse with every year,” Harry Johns, president and CEO of the Alzheimer’s Association, said in a statement. Health officials and policymakers already dread the coming crisis from the disease, which has no cure and no effective treatment.

In its annual report, the Alzheimers Association said Medicare payments for a dementia patient than for seniors without Alzheimer’s or another dementia. lzheimer’s and other dementias are nearly three times higher and Medicaid payments 19 times higher The price tag is 19 times higher for Medicaid patients with dementia.

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THURSDAY, March 8 (HealthDay News) — Caring for people with Alzheimer’s disease and other types of dementia will cost the United States about $200 billion this year, a total that includes $140 billion paid by Medicare and Medicaid, new statistics released Thursday show.

Medicaid payments are 19 times higher for seniors with Alzheimer’s and other dementias and Medicare payments for the conditions are nearly three times higher, compared to payments for other patients, according to the “2012 Alzheimer’s Disease Facts and Figures” report from the Alzheimer’s Association.

Nearly 30 percent of people with Alzheimer’s and other dementias are covered by both Medicare and Medicaid, compared to 11 percent of people without the conditions. This means that Medicare and Medicaid costs associated with Alzheimer’s and other dementias will continue to rise as baby boomers age, the report said.

“Alzheimer’s is already a crisis, and it’s growing worse with every year,” Harry Johns, president and CEO of the Alzheimer’s Association, said in an association news release.

“While lives affected and care costs soar, the cost of doing nothing is far greater than acting now. Alzheimer’s is a tremendous cost-driver for families and for Medicare and Medicaid. This crisis simply cannot be allowed to reach its maximum scale because it will overwhelm an already overburdened system,” Johns added.

Most people with Alzheimer’s and other dementias have at least one other serious chronic health problem, and Alzheimer’s acts as a “cost multiplier” on these other diseases, according to the report.

For example, the statistics showed a senior with diabetes and Alzheimer’s costs Medicare 81 percent more than a senior with diabetes alone. And a senior with cancer and Alzheimer’s costs Medicare 53 percent more than a senior with cancer alone.

Mental impairment in patients with Alzheimer’s and other dementias complicates the management of care, resulting in more and longer hospital stays, the authors noted in the news release.

“This disease must be addressed on parallel tracks: supporting research to find treatments that cure, delay or prevent the disease, and offering assistance and support to the more than 5 million Americans now living with Alzheimer’s and their more than 15 million caregivers,” Johns said.

“This is what the National Alzheimer’s Plan is all about. Caring for people with Alzheimer’s and other dementias costs America $200 billion in just one year. By committing just 1 percent of that cost, $2 billion, to research, it could begin to put the nation on a path to effective treatments and, ultimately, a cure,” he noted.

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7 March 2012 Last updated at 19:23 ET

The use of a tracking device to help people with dementia maintain a degree of independence is to be trialled by NHS Dumfries and Galloway.

The Buddi system allows those wearing the GPS-linked equipment to stay active without fear of getting lost.

The tracker can also be activated to call for emergency help, and to alert carers and relatives to a fall.

The health board’s nurse director, Hazel Boreland, said it could help to keep people “in a safe environment”.

She described it as an “innovative system” which could give added peace of mind to carers and families.

“Anything that can help patients with dementia maintain an increased level of safe independence has to be something that we test,” she said.

“So that is why we are giving it a go.”

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LONDON (Reuters) – Pfizer’s dementia drug Aricept, already commonly used to treat mild to moderate Alzheimer’s disease, can also help patients with severe disease and should be used more widely and for longer, according to research published on Wednesday.

British scientists who studied the possible longer-term benefits of giving Aricept suggested that extending treatment could help twice as many Alzheimer’s sufferers worldwide.

The study also looked at another commonly used dementia drug called memantine, which is sold in the United States under the brand Namenda by Forest Laboratories and Germany’s Merz, and in Britain under the brand Ebixa by Danish group Lundbeck.

It found that keeping patients with moderate to severe Alzheimer’s on Aricept, or donepezil as it is known generically, or starting them on memantine treatment, meant they had significantly better cognitive and function abilities than patients taking a placebo or dummy pill.

An estimated 18 million people worldwide suffer from Alzheimer’s disease, which is the most common form of dementia. It is fatal brain disease that affects memory, thinking, behaviour and the ability to handle daily activities and is placing an increasingly heavy burden on societies and economies across the world.

According to the World Health Organisation, some 35 million people worldwide have dementia, and Alzheimer’s Disease International predicts that as populations age, dementia cases will almost double every 20 years to around 66 million in 2030 and 115 million in 2050.

The study, published in the New England Journal of Medicine, involved 295 Alzheimer’s patients in Britain who were assigned to one of four separate groups – one continuing to take donepezil, one stopping donepezil and getting a placebo, one stopping donepezil and starting memantine, and a fourth taking both drugs together.

Robert Howard, a professor at King’s College London who led the trial, said it was the first to show the value of continued drug treatment for patients with moderate to severe Alzheimer’s.

While donepezil is commonly prescribed for patients in the early stages of the disease, doctors in some countries, including Britain, are advised to stop prescribing the drug to patients once their disease has progressed to become more severe.

“As patients progress to more severe forms of Alzheimer’s disease, clinicians are faced with a difficult decision as to whether to continue or not with dementia drugs and, until now, there has been little evidence to guide that decision,” Howard told reporters at a briefing abut his findings.

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WEDNESDAY, March 7 (HealthDay News) — New research suggests that pregnancy may decrease women’s risk of developing multiple sclerosis.

“Even one pregnancy was associated with nearly a halving of risk [of developing MS symptoms],” said study author Anne-Louise Ponsonby, head of the environmental and genetic epidemiology and research group at Murdoch Children’s Research Institute in Melbourne, Australia. The team also found that women who were pregnant two or more times had only one-quarter of the risk of developing MS symptoms as those who were never pregnant.

The study was published online March 7 in the journal Neurology.

Previous research has found that pregnancy in women who already have MS — an autoimmune disorder — is linked with lower rates of relapse.

Ponsonby’s team found an association between pregnancy and a lower risk of MS symptoms, not a direct cause-and-effect link. They say, however, that this association may help explain why the incidence of MS in women has inched up over the past few decades, as more women delay pregnancy or have fewer babies or none at all.

The researchers evaluated information on 282 Australian men and women, aged 18 to 59, who had MS symptoms — which can include fatigue, numbness, balance or walking problems — but had not been diagnosed with the disease. The researchers looked at both the number of live births and pregnancies lasting at least 20 weeks in the women. They also recorded the number of children born to men. They compared those statistics to 542 men and women without MS symptoms.

No link was found between the number of children men had and their risk of MS symptoms. There was an association with women, however: the risk of developing MS symptoms decreased as the number of pregnancies increased.

The researchers couldn’t say exactly why pregnancy may lower MS risk, but they speculated it could be the increase in estrogen during pregnancy or the effect pregnancy has on inflammatory genes involved in MS.

The study was funded by the National Multiple Sclerosis Society and other organizations.

Women are more likely than men to develop MS. Having a close relative with MS also increases your risk. About 400,000 people in the United States have MS, according to the National Multiple Sclerosis Society.

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Women who have been pregnant two or more times had a reduced risk of developing the disease, study finds. (Paul Sakuma / Associated Press)

March 7, 2012, 1:17 p.m.

Pregnancy is known to cause a remission in symptoms of multiple sclerosis in women who have MS prior to becoming pregnant. Now a study has found that multiple pregnancies may help prevent MS from ever developing.

The study, published online Wednesday in the journal Neurology, reviewed information on 282 men and women who received a diagnosis of central nervous demyelination. That’s a condition that reflects early symptoms of MS but falls short of an actual MS diagnosis. The researchers compared those people to 542 healthy men and women.

They found that women who have been pregnant two or more times had a reduced risk of developing the disease. Women who had five or more pregnancies had one-twentieth the risk of developing MS compared with women who were never pregnant. There was no effect on men regarding their number of offspring and onset of the disease.

Rates of MS have increased over the last several decades. This increase could reflect the fact that women are having fewer children, said the lead author of the study, Anne-Louise Ponsonby of Murdoch Children’s Research Institute in Melbourne, Australia. It’s not clear what it is about pregnancy that protects against MS or causes its temporary remission. It’s likely that hormones play a role, and studies are underway looking at estrogen as a treatment for the illness. It’s also possible that immune changes that take place during pregnancy alter symptoms of the disease as well as the risk of developing it.

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Public release date: 7-Mar-2012 [ | E-mail | Share ]

Contact: Michael Bernstein m_bernstein@acs.org 202-872-6042 American Chemical Society

With the “Refrigerator Mother” notion about the cause of autism a distant and discredited memory, scientists are making remarkable progress in untangling the genetic roots of the condition, which affects millions of children and adults, according to an article in the current edition of Chemical & Engineering News. C&EN is the weekly newsmagazine of the American Chemical Society, the world’s largest scientific society.

In the story, C&EN Associate Editor Lauren K. Wolf points out that most people in the 1960s believed autism resulted from a lack of maternal warmth and emotional attachment. It was a hypothesis popularized by Austrian-born American child psychologist and writer Bruno Bettelheim. Now scientists around the globe are focusing on genes that have been implicated in autism and related conditions, collectively termed “autism spectrum disorders.” That research may solve mysteries about autism, which affects 1 in 110 children in the U.S. Among them: what causes autism, why does it affect more boys than girls and what can be done to prevent and treat it?

C&EN explains that scientists now have solidly implicated certain genes as being involved in autism. Most of those genes play a role in the transmission of signals through the junctions or “synapses” between nerve cells. Synapses are the territory where one nerve releases a chemical signal that hands off messages to an adjoining nerve. The human brain has an estimated 1,000 trillion synapses, and they are hot spots for miscommunications that underpin neurological disorders like autism. Scientists now are gleaning information on what those genes do, what brain circuits they affect and how the proteins they produce function. In doing so, they are paving the way for future medications for autism spectrum disorders.

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